A number of suturing techniques to close wounds during healing are well known in the art. These include the use of closure and/or retention sutures of plastic or nylon that are sewn into the skin to bring the marginal edges of the skin around the wound together and hold them in position during healing. An alternative to sewn sutures are staples that extend across the wound at spaced locations along the length of the wound.
It should be recognized that while each of these approaches does effectively hold a wound closed for healing, each suffers from distinct disadvantages as well. Both sewn sutures and staples are invasive techniques that penetrate and damage the interior tissues of the body. Being invasive, these sutures also act as wicks for infection caused by foreign bodies and germs. The use of invasive sutures also prevents effective application of cleansing and healing agents to the wound. Further, in the event infection does develop, the wound may need to be reopened, requiring the painful removal of the invasive sutures and subsequent reclosing with sutures, further damaging the interior body tissues.
While staples may not damage the interior tissues to the extent of sewn sutures, staples do not provide an even closing pressure all along the wound. Rather, staples provide spaced points of localized pressure along the wound that can lead to uneven healing and increased scarring. Further, it should be appreciated that being invasive, both staples and sewn sutures must be removed from the patient before the skin tissues completely heal around them. Such early removal makes it necessary to provide some closing pressure to the wound as a prophylaxis to prevent rupture or reopening.
Recognizing the shortcomings of invasive suturing techniques, butterfly sutures including adhesive strips placed across the wound have been more recently developed. These noninvasive sutures avoid any damage to the interior tissues as well as the wicking action that may lead to infection. Still, with past adhesive strip sutures it has been difficult to properly align the skin margins around the wound during application. Further, past noninvasive sutures have suffered from an inability to protect the wound from opening when subjected to shear loading as may occur during certain body movements. They have also failed to allow the application of cleansing and healing agents to the wound as may be desired. A need is, therefore, identified for an improved noninvasive strip suture.